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Randomized Controlled Trial Multicenter Study
Deliberative democracy and cancer screening consent: a randomised control trial of the effect of a community jury on men's knowledge about and intentions to participate in PSA screening.
- Rae Thomas, Paul Glasziou, Lucie Rychetnik, Geraldine Mackenzie, Robert Gardiner, and Jenny Doust.
- Faculty of Health Sciences and Medicine, Centre for Research in Evidence-Based Practice (CREBP), Bond University, Gold Coast, Queensland, Australia.
- BMJ Open. 2014 Jan 1;4(12):e005691.
ObjectiveProstate-specific antigen (PSA) screening is controversial. A community jury allows presentation of complex information and may clarify how participants view screening after being well-informed. We examined whether participating in a community jury had an effect on men's knowledge about and their intention to participate in PSA screening.DesignRandom allocation to either a 2-day community jury or a control group, with preassessment, postassessment and 3-month follow-up assessment.SettingParticipants from the Gold Coast (Australia) recruited via radio, newspaper and community meetings.ParticipantsTwenty-six men aged 50-70 years with no previous diagnosis of prostate cancer.InterventionThe control group (n=14) received factsheets on PSA screening. Community jury participants (n=12) received the same factsheets and further information about screening for prostate cancer. In addition, three experts presented information on PSA screening: a neutral scientific advisor provided background information, one expert emphasised the potential benefits of screening and another expert emphasised the potential harms. Participants discussed information, asked questions to the experts and deliberated on personal and policy decisions.Main Outcome And MeasuresOur primary outcome was change in individual intention to have a PSA screening test. We also assessed knowledge about screening for prostate cancer.ResultsAnalyses were conducted using intention-to-treat. Immediately after the jury, the community jury group had less intention-to-screen for prostate cancer than men in the control group (effect size=-0.6 SD, p=0.05). This was sustained at 3-month follow-up. Community jury men also correctly identified PSA test accuracy and considered themselves more informed (effect size=1.2 SD, p<0.001).ConclusionsEvidence-informed deliberation of the harms and benefits of PSA screening effects men's individual choice to be screened for prostate cancer. Community juries may be a valid method for eliciting target group input to policy decisions.Trial Registration NumberAustralian and New Zealand Clinical Trials Registry (ACTRN12612001079831).Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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